Home use device and method for treating skin conditions

ABSTRACT

Skin tissue is subjected to thermal energy that creates heating of the area being treated causing pores and follicle ducts to open so that excess oil, sebum, fatty deposits, or other unwanted deposits can be removed. A vacuum device is used to direct suction to the treated skin area helping to remove the unwanted deposits. Patterned thermal modification of tissue is used to expedite healing and minimize pain. The heating is controlled so that no skin tissue is damaged while still providing enough heat to the skin to alter the flow of sebum and destroy bacteria in the treated area.

BACKGROUND CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent applicationSer. No. 13/163,694, filed on Jun. 19, 2011, which is a continuation ofU.S. patent application Ser. No. 11/752,893, filed May 23, 2007, nowU.S. Pat. No. 7,981,112, issued on Jul. 19, 2011, and which also is acontinuation-in-part of U.S. patent application Ser. No. 11/234,771,filed Sep. 23, 2005 which claims priority to U.S. Provisional PatentApplication Ser. No. 60/615,510, filed Oct. 2, 2004, Ser. No.60/704,602, filed Aug. 1, 2005, and Ser. No. 60/678,968, filed May 9,2005; and which also further claims priority to U.S. Provisional PatentApplication Ser. No. 60/802,960, filed May 23, 2006, and U.S.Provisional Patent Application Ser. No. 60/921,901, filed Apr. 4, 2007;all of which are incorporated herein in their entirety by reference.

BACKGROUND

The present invention relates generally to the application of energy tobiological tissue, and specifically to the application ofelectromagnetic energy to the skin in order to treat various skindiseases.

It is known in the art to apply electromagnetic energy to biologicaltissue to engender changes therein. Sunbathers, for example, regularlyexpose themselves to bright sunlight in order to increase melanocyteactivity in the basal layer of the epidermis, responsive to the sun'sultraviolet (UV) radiation. Artificial UV sources have been created tosatisfy the desire for a healthy-looking tan in the winter. Other formsof electromagnetic energy, laser-light in particular, are currently usedin a large range of therapeutic and cosmetic procedures, including eyesurgery, hair removal, wrinkle removal, and tattoo removal.

PCT publication WO 98/55035, which is incorporated herein by reference,describes methods for minimizing injury to biological tissue surroundinga site exposed to pulses of electromagnetic energy. This and all otherextraneous materials discussed herein are incorporated by reference intheir entirety. Where a definition or use of a term in an incorporatedreference is inconsistent or contrary to the definition of that termprovided herein, the definition of that term provided herein applies andthe definition of that term in the reference does not apply.

U.S. Pat. No. 5,720,894 to Neev et al., which is incorporated herein byreference, describes biological tissue processing using Ultrashort PulseHigh Repetition Rate Laser System for Biological Tissue Processing.

It is known in the art to use UV and blue light to cure acne. A beam ofshort wavelength light is irradiated and is supposed to destroy bacteriathrough sterilizing ability of the high energy photon to disruptmolecular bond and photochemical destruction of living cells. Thismethod is deficient however, because of the relatively short depth ofpenetration of the short wavelengths regime and the danger ofmutagenetic effect as well as the effective shielding of deeper lyingbacteria by superficial skin structures.

It is also known in the art to use chemical peels and tretinoin tochemically peel of the outer layer of the skin. This method is deficienthowever, because of side effect, long response time and longer timeduration between application of the treatment and results and variousside effects.

It is also known in the art to apply antibiotic to patients in order tocombat active acne. This method is deficient however, since theapplication of antibiotic is non-selective, often done systemically andthus affects the entire body, and also for the fact that variousorganisms and bacteria develop resistance to antibiotics and therebyincreases the risk of exposure to bacteria that are now resistant toantibiotics.

It is also known in the art to combat active acne by treating andcontrolling hormonal activity within a patient body. Again, this is asystemic approach that suffers from many side effects including, in somecases, severe depression, and impact on the entire body.

It is therefore desirable to have a simple, non-invasive, non-systemictreatment method and apparatus for the treatment and cure of acne, that,when applied, is free of side effects, yet is safe and effective. It isalso desirable to have a method that is easy to apply and is relativelyquick and easy to administer and produces rapid skin response, relief ofsymptoms, and cure for the condition.

It is also desirable to have a simple, safe, non-invasive, non-systemictreatment method and apparatus for the treatment and cure of other skindiseases and skin conditions, that, when applied, is free of sideeffects, yet is safe and effective. Finally, it is particularlydesirable to have a safe, home use, small and compact device thatconsumers can carry with them or use in the home or office environmentfor treatment of pimples, acne, or minor skin conditions, with orwithout the application and use of medicine or topical medication, toresolve irritating skin conditions, including acne.

SUMMARY OF THE INVENTION

The present invention provides methods and apparatus in which a regionof intact living skin is treated with energy pulses having a duration ofshort duration, at an average energy density such that a temperature atthe surface rises to at least 45° C. without substantially denaturingtissue at the epidermal/dermal junction. The basic principle is to heatup the surface of the skin with sufficient heat to cause opening of thepores, but limit the amount of energy such that when it is diffused anddistributed over a larger volume (in the dermis), the energy is belowthat which would cause substantial denaturation of cells in the skin.

In especially preferred embodiments the energy pulses are produced by anelectric heater coupled to a capacitor and a battery, the capacitordischarges between 0.2 J/cm² to 10 J/cm² and preferably between 0.5J/cm² and 5 J/cm² and most preferably between 0.7 J/cm² and 3 J/cm² inpulses of between 0.1 ms and 10 ms. The energy pulses are preferablyelectromagnetic radiation that includes visible wavelengths.

To avoid overheating of, and damage to, the dermis and underlyingtissues, the pulses have durations of less than 30 seconds, morepreferably less than 10 seconds, and in some cases less than 1 second,less than 0.1 sec, or even less than 0.01 sec. Pulses can be repeated atany desirable frequency, including especially between 0.5 second and 10seconds, and more preferably between about 2 seconds and 5 seconds.Unless a different meaning is dictated by the context, all ranges hereinshould be interpreted as being inclusive of their endpoints. Interpulsedelays of between 0.2 sec and 10 sec are preferred, with interpulsedelays of between 2 sec and 5 sec even more preferred. Thus, it iscontemplated that the controller could cooperate with the energy sourceto subject the treatment region to at least 2 energy pulses within a 20second period, and possibly at least 10, 25, 50, 75 or even 100 suchenergy pulses within a 20 second period.

In other aspects of preferred embodiments, the tip treatment area ispreferably between 0.2 mm and 10 cm in diameter, and preferably betweenabout 2 mm and about 2 cm in diameter.

From a method standpoint, it is contemplated to operate a device asdescribed herein such that hair follicles in the skin expand withoutbeing permanently damaged. By appropriately selecting pulse energydensity, pulse width, and interpulse delays, it is possible to raise thesurface temperature of the skin at least 60° C. or even 70° C. or morewithout substantially denaturing tissue at the epidermal/dermaljunction. In some cases this effect can be facilitated by activelycooling the surface of the skin to a temperature of less than 50° C.

It is still further contemplated that operation of devices as describedherein can include treating the skin with anti-microbial radiation thatincludes blue to ultraviolet wavelengths (to achieve an antimicrobialeffect), and applying a vacuum to the skin within 5, 10, or 15 minutesof application of the pulse (to help remove debris released during theheating portion of the treatment).

In a preferred embodiment of the present invention, the tissue of theskin is subjected to localized heating for a given time and in a definedlocation, which elevates the temperature of the skin in that location ascompared to its normal temperature. This elevation of skin temperaturecorresponds to expansion and displacement of a portion of the skin, thusleading to the opening of skin pores.

In another preferred embodiment of the present invention, the tissue ofthe skin is subjected to localized heating for a given time and in adefined location, which elevates the temperature of the skin in thatlocation as compared to an adjacent location. This elevation of skintemperature corresponds to expansion and displacement of a portion ofthe skin with respect to the adjacent location, thus leading to theopening of skin pores.

In a further preferred embodiment, an intermediate substance, which iscapable of absorbing at least a portion of the electromagnetic energyfrom a source, is placed between the energy source and the skin. Theintermediate substance absorbs the source energy and converts it toheat. Being in contact with the skin, the intermediate substanceelevates the temperature of the skin to cause to an expansion anddisplacement, leading to the opening of skin pores and relieving of acneconditions.

In yet a further preferred embodiment, an intermediate substance, whichis capable of absorbing at least a portion of the electromagnetic energyfrom a source, is placed between the energy source and the skin. Theintermediate substance absorbs the source energy and converts it toheat. Being in contact with the skin, the intermediate substanceelevates the temperature of the skin in one location as compared to anadjacent location. This elevation of skin temperature corresponds toexpansion and displacement of a portion of the skin with respect to theadjacent location, thus leading to the opening of skin pores.

As will be apparent from the description contained herein, aspects ofthe inventive subject matter include: a. Providing an improved apparatusand methods for applying energy to a material; b. Providing improvedapparatus and methods for removing heat generated during application ofelectromagnetic energy to a material; c. Providing improved apparatusand methods for removing heat generated during application ofelectromagnetic energy to biological tissue; d. Providing improvedapparatus and methods for decreasing pain during application ofelectromagnetic energy to biological tissue; e. Providing improvedapparatus and methods for performing medical treatments; f. Providingimproved apparatus and methods for performing cosmetic treatments; g.Providing improved apparatus and methods for healing of skin diseasesand skin illnesses; h. Providing improved apparatus and methods forenabling electromagnetic energy source to allow healing of skin diseasesand skin illnesses or improved conditions; i. Providing methods andapparatus for enabling a chemical, RF, Microwave, mechanical, electric,magnetic, or ultrasound energy to advance healing skin diseases and skinillnesses; j. Providing improved methods and apparatus for enabling alow-power electromagnetic energy source to advance healing skin diseasesand skin illnesses substantially without pain, while substantiallyminimizing the amount of damage or modification to remaining tissue; k.Providing improved methods and apparatus for enabling a low-powerelectromagnetic energy source to perform skin treatment, treatment ofacne and treatment that prevent the occurrence of acne; l. Providingimproved methods and apparatus for enabling a low-power electromagneticenergy source to perform tissue treatment that cures acne and relievessymptoms of acne.

These and other objects, features, aspects and advantages of theinventive subject matter will become more apparent from the followingdetailed description of preferred embodiments, along with theaccompanying drawings in which like numerals represent like components.

BRIEF DESCRIPTION OF THE DRAWINGS

In the accompanying figures, like elements are identified by likereference numerals among the several preferred embodiments of thepresent invention.

FIG. 1A is a simplified diagram of an apparatus for treatment of acneand skin condition and its components.

FIGS. 1B and 1C are simplified diagrams of contemplated heatingelements.

FIG. 1D is a simplified diagram of an array of heating elements.

FIG. 1E is a simplified diagram of an alternative treatment head.

FIG. 2 is a simplified diagram showing a representative heataccumulation and temperature vs. pulse number effect on the skinsurface.

FIG. 3 is a simplified diagram of a possible circuit diagram for anelectric heater skin and acne treatment device.

FIG. 4 is a simplified diagram showing how a handheld skin treatmentdevice is used to treat the skin.

FIG. 5 is a simplified block diagram of device components

FIG. 6 is a simplified diagram of an acne and skin treatment deviceutilizing an energy source and a source of suction to enhance treatment.

FIG. 7 is a simplified diagram showing a schematic representation of asurface of the skin or tissue treated with a pattern of thermalmodification to minimize collateral damage and enhance healing time.

DETAILED DESCRIPTION OF THE INVENTION

Devices and methods are contemplated herein for treatment of a varietyof skin conditions, and in particular, cyst, acne, aged skin, andwrinkles. In FIG. 1A the device 3, designed to treat a skin surface 5,comprises the following components: an energy source 10, for example, abattery, an electro-mechanical dynamo, or an electric wall outlet, amongother possible energy sources, that provides energy to the devicecontrol elements 30, for example a control element on a circuit board35. The device control elements 30 are activated by input switches (notshown), for example, a power level switch, a trigger switch, or anoff/on switch, that allows the user to interface with the device, forexample they allow the user to control the operation, power level andactivation of the device. The device control elements 30 allows theenergy source 10 to power a treatment head 50 directly or to charge up aplurality of capacitors 55 or other intermediate elements (resistors,diodes, etc.) that modify the energy output of the treatment heads. Thetreatment head 50 can include a resistor that provides heating to theskin by diffusion.

In preferred embodiments of FIGS. 1B and 1C, the treatment head 50 canbe made from a heating element, for example a resistor 53 can beembedded in an insulating material 57, for example PTFE or a plasticmaterial that is sufficiently thin to allow rapid conduction of thethermal energy to the skin. In another preferred embodiment, theresistor 53 can be made of a conductor in a flat configuration so thatit conducts heat uniformly in a planar configuration of temperaturegradient as shown in FIG. 1C. This will allow the heat to diffuse as aflat planar diffusion of thermal energy to the skin. The resistor 53 canbe mounted on a layer of glass or PTFE, plastic, or other insulatingmaterial 57, which reduces removal of thermal energy from the resistor,and facilitates diffusion of the thermal energy by conduction towardsthe targeted skin. Between the resistor 53 and the target skin one canadvantageously include a thin layer of electrically insulating material57 that prevents electricity from the resistor 53 from reaching the skinbut allows thermal energy from the resistor 53 to reach the skin. Theresistor 53 can be made of typical materials known in the art such ascopper, aluminum, tungsten, steel, nichrome, or copper and tin alloys.

Resistor 53 can advantageously be coated with a thin layer ofelectrically insulating but thermally conducting material that allowsthe heat to flow but prevents electric current from reaching theskin—for example by anodizing processes. The treatment head 50 can haveany suitable thickness, preferably 10 micrometers to 1 mm, morepreferably between 25 micrometers and 500 micrometers, and mostpreferably between 50 micrometers and 200 micrometers. The electricalinsulating layer 57 can also have any suitable thickness, preferablybetween 5 micrometers and 1 mm, more preferably between 10 micrometersand 500 micrometers, and most preferably between 20 micrometers and 250micrometers.

Because the maximum amount of energy that is loaded up onto the heaterelement is the maximum amount of energy (or heat) available to treat andalso to possibly cause excessive collateral damage, it determines theupper limit of the risk of the method and the device contemplatedherein. The upper limit of the amount of energy provided by the resistor53 is determined by its heat capacity (for example, the most energy aheating element can have is the full amount of energy from a dischargingcapacitor, ½ CV², where C is the capacitor capacitance and V is thefinal voltage across the capacitor). If the heating element 53 iscompletely insulated, and is designed to reach a temperature increase DTabove normal skin temperature (for example, if we designate DT=200° C.),then the amount of energy that will allow it to reach that temperatureis determined by the heat capacity of the heating element 53. The heatcapacitance is a function of the heating element volume and hence for adesignated treatment area (for example between about 0.2 cm² to about 9cm², and preferably 2 cm²) a thinner heating element will have smallerheat capacitance and hence will store less energy, corresponding to itsdesignated temperature DT. Thus, by proper design of the heatcapacitance and thickness of the heater, we can calculate and limit theupper value of energy available for transfer into the skin. For thisreason, a thin heater will serve to limit the amount of energy availablefor heating of the skin. For example, a total thickness of the heatingelement 53 should be between 20 micrometers and about 500 micrometers,and preferably between about 30 micrometers and about 300 micrometers.As shown in FIG. 1C, the wires 58 provide current to the resistiveheating element 53.

A temperature monitoring element 67 (for example, a thermocouple or anIR detector, such as an HgCdTe detector) can be integrated into theheating element as shown in FIG. 1A, and be operatively coupled to theheating element 53. A cooling element 69, for example a thermoelectriccooler (or TEC), can also be integrated into the treatment head 50 toreduce the temperature of the treatment head 50 before the next shot isfired. For example, a reduction in temperature range between about 25°C. to 45° C., and preferably between about 27° C. and about 37° C., canbe required before the device can be fired again.

As shown in FIG. 1D, a plurality of treatment heads can be used. Thus,heads 51, 52 can be used while treatment head 50 is cooling. Forconvenience, the treatment heads 50, 51 and 52 can all be mounted on aconveyer belt or other actuator, and thereby moved in the direction ofthe arrow 61.

In FIG. 1E an alternative treatment head 75 includes heating element 53mounted on insulating material 57 and flexible layer 59. Treatment head75 is flexible, and is mounted on a collapsible/extendable rack 70,which can be extended or expanded in the direction of the arrows 73,pulling with it the entire assembly of treatment head 75, in respect toa variable treatment area 77. The variable size treatment area 77 canrange, for example, from about 0.5 mm in diameter to about 5 cm indiameter, and preferably from about 2 mm in diameter to 25 mm indiameter.

The above treatment head cooling and adjustable head size may not benecessary if a simple handheld device is desired. Thus, in general, apreferred embodiment includes a device for treatment of skin conditionscomprising: an energy source adapted and configured to provide energy tothe skin surface; and a controller adapted and configured toautomatically energize the energy source so it heats the skin to atemperature sufficient to loosen, dislodge, destroy or otherwisedesirably modify the blockage within a follicle so as to allow drainagethereof in response to a user input.

Heating elements 53 can be coated for several reasons, including toenhance safety, to provide quicker temperature changes, and for improvedpatient experience. For example, as shown in FIGS. 1B and 1C a resistor53 can be embedded in an insulating material 57. For example, PTFE orother plastic or glass electrically insulating materials that allow theheat to thermally conduct and reach the skin 5 can be used. In somecontemplated embodiments, a thin electrically insulating coating (forexample, a thin plastic coating can be applied or an anodizing processcan be used) can be applied to the resistor 53 to prevent electricalcurrent from reaching the skin 5, while still allowing heat to diffuseand reach the skin 5.

It is contemplated that controller 30 can operate to cease providingenergy to the heating element 53, and to reheat the heating element 53without a further user input.

It is also contemplated that energy provided to the skin can causessubstances inserted in the hair follicle to expand.

It is also contemplated that the energy source 10 and controller 30 canbe co-located in a housing, and that the housing can be sized anddimensioned to be hand held.

One or more energy removal (i.e., cooling) elements 69 may also be used.The energy removal element 69 should be adapted and configured to coolsaid heating element 53 and/or a skin surface 5 to a temperature of lessthan about 50° C., and an electromagnetic source of energy in the blueto ultraviolet range is also applied to achieve sterilization of theskin 5.

Particularly preferred methods and apparatus include: a heating element53 adapted and configured to contact a skin surface 5; and a controller30 adapted and configured to automatically heat the heating element 53to a temperature sufficient to loosen, dislodge, destroy or otherwisedesirably modify a blockage within a follicle or improve the conditionand health of the skin 5 in response to a user input. Such devices canadvantageously raise the temperature surface of the skin 5 to above 38°C., more preferably to above 45° C., and in some cases could transientlyraise the temperature of the surface of the skin 5 to 70° C., or even100° C., 200° C., 250° C., 300° C., 350° C. or more.

Of course, such high temperatures would be maintained for only a shortperiod of time, to avoid substantial permanent damage to the majority ofthe living cells in the skin. Thus, the contemplated devices and methodswould preferably not be applied in an ablative manner. To that endelevated heating of the surface of the skin would typically occur for aheating period that is less than about one second, more preferably lessthan about 0.1 second more preferably yet less than about 0.01 secondand most preferably less than about 1 ms.

Also contemplated herein are methods of treating a subject having a skinlesion, comprising applying energy to a lesion; heating the lesion to atemperature sufficient to modify skin condition and treat disease butcause serious burn; and repeating the energy applications and heatingsteps at least one time.

For example, if an electric current is used to heat up a resistor, forexample by charging up and discharging a capacitor through the resistoras is contemplated by one preferred embodiment, or, for example, byproviding a DC or AC current through the resistor adapted to contact theskin, and using automated or manual interruption to terminate thecurrent flow and heating phase, then repeating the heating cycle willresult in accumulation of heat in the skin and temperature build up, forexample, as shown in FIG. 2.

As shown in FIG. 2, the temperature of the skin due to the first heatingcycle 210 is a peak temperature, for example, 300° C., and then decaysto lower values due to conduction to the skin 5 and some loss to theinsulating material 57 of FIG. 1A. A second pulse, for example a fewseconds later, may raise the temperature of the skin 5 which has not yetbeen able to decay to its normal ambient temperature, for example 37°C., and has only reached a lower temperature of 45° C., will now riseagain due to cycle number 2, for example to a peak temperature of 310°C. as shown in 220. A third pulse will raise the peak temperature forexample to 320° C. peak and will decay to a temperature of, for example,50° C. We can see that the accumulation of thermal energy from repeatedheating cycles 1, 2, 3, and 4, as shown by the curves 210, 220, 230 and240, will result in a slow average skin temperature increase, as shownby the curve 250 from its ambient temperature 37° C. to an elevatedtemperature of 50° C. The tail of the curve 210 (broken line) shows whatthe decay of a single pulse will look like.

The number of such repeated heating cycles should there be limited orspaced apart by several seconds to allow cooling between pulses, orutilize active cooling such as thermoelectric cooling or cryogen spraycooling incorporated with the method or device to prevent accumulationof excess heating of the skin surface, which can lead to deeper tissueeffects or burn. The heating step, if done through a slower heatingprocess, should be limited in time or monitored with the thermocouple 67of FIG. 1A. If limited in time, this preferred heating step shouldpreferably be limited to less than 3 minutes, more preferably to lessthan 1 minute, more preferably yet to less than 30 second, morepreferably yet to less than 1 second, more preferably yet to less than100 ms, more preferably yet to less than 10 ms, more preferably yet toless than 1 ms, and more preferably yet to less than 0.1 ms.

In an additional preferred embodiment, an electrical device 3 for thetreatment of skin lesions comprises: (a) an interface 50 for contactingthe skin 5 of a subject; (b) a heater 53 capable of heating theinterface to a temperature sufficient to cause expansion of a hairfollicle and treatment of skin conditions without irreversible damage toliving cells. The device 3 may optionally include an energy removal(i.e., cooling) element 69, preferably capable of cooling the heatingelement 53 and/or treatment surface to a temperature of less than about50° C. Still further, the device 3 may include a source ofelectromagnetic energy 87 in the blue to ultraviolet range, which can beapplied to at least partially sterilize the skin 5.

FIG. 3 shows one possible circuit diagram to pulse a flash lamp 350. Aswitch 320 is turned on to draw power from battery 310, throughtransformer 330, to activate the device and charge the capacitor 340.When the capacitor is fully charged a lamp 345 (or LED) is turned on andthe circuit is ready to fire. Push button 360 is pressed to dischargecapacitor 340. After firing, the capacitor 340 begins to charge, andafter several seconds (depending on the battery and resistance) is fullycharged. This circuit releases a maximum energy per pulse of ½ CV²,where C is the capacitance of capacitor 340 and V is the final voltageacross the capacitor 340. By selecting appropriate values of C and V,the released energy can be kept at the appropriate level so it loads upsufficient amount of energy into the top layer of the tissue. Forexample, a discharge time of 1 ms will allow diffusion into about 30micrometers of tissue with thermal conductivity similar to that ofwater, thus the amount of energy in this tissue should be enough tocause a temperature jump high enough to cause sufficient tissueexpansion so that pores and spacing in the epidermis are opened to allowhealing of acne and other skin conditions. However, the amount of energydischarged and conducted into the tissue is not enough to cause seriouscollateral damage or a serious burn, because the total amount of energyper unit volume conducted into the deeper tissue, i.e. less than ½ CV²,is too low to interact with the living cells and cause significantirreversible damage or a serious burn.

FIG. 4 shows how the device 420 can be used by a consumer suffering fromacne or other skin conditions. The user 410 holds the device 420 in hishand 430, and pushes a charge button 440 to initiate charging and a firebutton 450 to fire the device 420 once it has made good contact with theuser's face.

In FIG. 5, 510 is a source of energy, for example, a battery or a wallplug; 520 is a user interface such as a power control, a charge button,and/or a fire button; 530 is a microprocessor powered by the powersource 510 and controlling the firing sequence, charging times, firingrepletion rate, and power levels, the microprocessor 530 beingresponsive to a user input; 540 is a capacitor and pulse generatorassembly capable of using the power source 510 to charge the capacitorand store the electrical energy; 550 is the full charge indictor tellingthe user that the device is ready to fire; and 560 is a heater adaptedto contact the skin to heat the skin surface to the required level.

An additional preferred embodiment of the present invention contemplatesa device for treatment of skin conditions and acne, the devicecomprising: an energy source adapted and configured to provide energy tothe skin surface; a controller adapted and configured to automaticallyenergize the energy source so it heats the skin to treat said skinconditions and acne; and a vacuum source to be applied to the skinbefore, during or after the energy application to said skin. In apreferred embodiment, an energy source is applied to the skin. Theenergy may be, for example, a laser, a broad lamp, a flash lamp, an RFenergy source, an ultrasound beam, or a microwave energy source.

As shown in FIG. 6, the device 605 comprises an energy source 610 whichdelivers energy to the surface of the skin 650 of a user 630. A sourceproviding suction, for example a vacuum pump 640, delivers suction tothe surface of the skin 650 at the same location that the energy isapplied. The suction can be applied to the skin 650 before, during, orafter the application of energy to the skin 650. The suction can helpclean pores, enhance energy delivery to target tissue and skincomponents, remove debris, sebum, fat, bacteria, or smoke from thesurface, clean pores and hair follicle openings as well as sweat pores,and minimize the sensation of pain. The source of energy 610 can be oneof the following: mechanical, thermal, electrical, optical,electromagnetic, ultrasound, microwave, nuclear, chemical, or RF energy.It emits a beam 620 that can be manipulated with lenses, mirrors andscanners 635, as well as other optical components 625, or may be adaptedto directly contact the skin 650 of the user 630.

In an additional preferred embodiment, the device 605 may also comprisean intermediate element capable of converting some energy to thermalenergy and conducting sufficient thermal energy to the skin to open andclean skin pores and follicle openings, treat skin ailments, and improveskin condition and look. The thermal energy thus generated may also beapplied in conjunction with the application of suction before, during,or after the thermal energy or other energy application.

In further preferred embodiments, the device 605 may additionally andpreferably comprise an energy removal element, said energy removalelement adapted and configured to cool said heating element and/or askin surface to a temperature of less than about 50° C., and anelectromagnetic source of energy in the blue to ultraviolet range isalso applied to achieve sterilization of the skin 650. A source ofcoolant 673, for example a gas container can dispense coolant, forexample through a coolant dispensing tube 677. Alternatively, a TEC canbe used to cool the target skin. The device 605 can advantageously alsoincorporate a contact suction head, for example a plurality of suctionheads 655 attached with a plurality of tubes 657 to a plurality ofvacuum pumps 640 so that the suction is applied to the targeted skinarea 650 before during or after the application of energy.

Devices and methods can also advantageously comprise: an energy sourceadapted and configured to provide energy to the skin surface; and acontroller adapted and configured to automatically energize the energysource so it heats the skin to a temperature sufficient to treat skinconditions and wrinkles. The device may further comprise an intermediatematerial, which may contain a substance capable of absorbing saidenergy, said absorbing substance arranged in patterns that maximize thepenetration of light while at the same time creating surface heating onthe skin surface. This will allow the deeper penetrating energy to heatfrom below while the upper surface heating creates heat flow downwardfrom the surface. The partial heating of the surface also allows fasterhealing as smaller portions of the epidermis are damaged. For example,surface heating of the upper layers of the skin can be between about 0%to about 70%, and preferably between 3% and 50%.

The intermediate absorbing material may contain a laser absorbingsubstance arranged in patterns that maximize the penetration of light todepths of between about 100 micrometers to about 1 mm in order tomaximize penetration of the light to heat the sebaceous glands andminimize secretion of sebum. The preferred density for deeper laserlight penetration and direct light heating of the upper layers of theskin is between about 0% to about 70% and preferably (if surface heatingutilizing the intermediate absorbing material is taken into account)between 3% and 50%. A laser in the blue to ultraviolet range can be usedin order to utilize the sterilization effect of these wavelengths, aswell as generating heat. The heat generation will be increased due tothe increased absorption resulting from the shorter wavelengths. Inaddition, blue and green to orange wavelengths are more readily absorbedby the hemoglobin in the blood and thus enhance heat generation at thesurface of the skin and in layers below the surface.

Various tissue conditions can be effectively treated using a pluralityof microscopic treatment zones. In that regard zones can be between 1micrometer in diameter and 7 mm in diameter, preferably between 20micrometers and 300 micrometers in diameter, and most preferably between50 micrometers in diameter and about 250 micrometers in diameter. Zonescan advantageously be created in a predetermined treatment pattern,wherein a subset of said plurality of discrete microscopic treatmentzones includes individual discrete microscopic treatment zones.

In FIG. 7, a pattern of treated spots 710 in the skin 725 is treated sothat at least some tissue modification takes place, and wherein thespaces between the spots are not treated. The extent of the spotsstretch to a depth 720. The spot diameter of the treated zone is asdescribed above. The percentage of the treated area can advantageouslyvary from 5% to 95%, more preferably from 20% to 80%, more preferablyyet from 30% to 70%, and most preferably from 40% to 60%. In especiallypreferred embodiments, the tissue can be modified in a region extendingfrom the surface to a depth of between about 25 micrometers to about 750micrometers, and more preferably from about 50 micrometers to about 400micrometers. The percentage of the modified or thermally modified tissueto unchanged tissue is preferably from about 0% to about 70% and morepreferably between 3% and 50%. The dotted line 727 represents theepidermal dermal junction and the line 728 represents the boundaries ofthe dermis. The depth 720 within which the tissue is modified thusextends to either the epidermis, the dermis, or both.

Thus, specific embodiments and applications of skin treating apparatusand methods have been disclosed. It should be apparent, however, tothose skilled in the art that many more modifications besides thosealready described are possible without departing from the inventiveconcepts herein. The inventive subject matter, therefore, is not to berestricted except in the spirit of the appended claims. Moreover, ininterpreting both the specification and the claims, all terms should beinterpreted in the broadest possible manner consistent with the context.In particular, the terms “comprises” and “comprising” should beinterpreted as referring to elements, components, or steps in anon-exclusive manner, indicating that the referenced elements,components, or steps may be present, or utilized, or combined with otherelements, components, or steps that are not expressly referenced. Wherethe specification claims refers to at least one of something selectedfrom the group consisting of A, B, C . . . and N, the text should beinterpreted as requiring only one element from the group, not A plus N,or B plus N, etc.

What is claimed is:
 1. A device for treating a region of intact livingskin having a surface and an epidermal/dermal junction, comprising: a.an energy source; b. a treatment head comprising an electricalresistance heater, a treatment tip having an area of between 0.2 cm² and9 cm² configured to be placed against a skin surface, and a layer ofelectrically insulating but thermally conducting material in thermalcontact with the treatment head, wherein the treatment head isconfigured to provide a thermal energy pulse at the treatment tipresponsive to energy provided by the energy source; c. a controller thatcooperates with the energy source to provide sufficient energy to theelectrical resistance heater to heat the treatment tip and therebycreate the energy pulse with the treatment head, wherein the controllercontrols and limits the energy provided to the electrical resistanceheater such that the energy is provided to the electrical resistanceheater to create an energy pulse; having a duration of no more than 100sec, and the energy pulse delivers an average energy density of 5 J/cm²or less from the treatment tip, and heats the treatment tip to atemperature of at least 50 degrees Celsius; and d. a source providingsuction.
 2. The device of claim 1, wherein the treatment tip has an areaof between 0.2 cm² and 9 cm².
 3. The device of claim 1, wherein theenergy is provided to the electrical resistance heater to create anenergy pulse having a duration of no more than 100 sec, and the energypulse delivers an average energy density of 5 J/cm² or less from thetreatment tip, and heats the treatment tip to a temperature of at least50 degrees Celsius.
 4. The device of claim 1, wherein the sourceproviding suction provides suction to the surface of the skin at thesame location that the energy is applied.
 5. The device of claim 1,wherein the source providing suction provides suction to the surface ofthe skin before the application of energy.
 6. The device of claim 1,wherein the source providing suction provides suction to the surface ofthe skin after the application of energy.
 7. The device of claim 1,wherein the source providing suction provides suction to the surface ofthe skin during the application of energy.
 8. The device of claim 1,wherein the source of suction is a vacuum pump.
 9. The device of claim1, further comprising a contact suction head connected to the sourceproviding suction.
 10. The device of claim 1 wherein the energy sourceand the controller are located in a common hand-holdable housing. 11.The device of claim 1 wherein a first side of the layer of thermallyconducting material defines the treatment area.
 12. A device comprising:a. a hand-holdable housing; b. an energy source, wherein the energysource comprises a battery and a capacitor; c. a heating elementcomprising a resistive heater and a treatment tip, wherein the treatmenttip comprises a diameter of between 0.2 mm and 10 cm; d. a controllerconfigured to trigger the capacitor to release its discharge capacity tothe heating element; and e. a source providing suction, wherein thecapacitor is configured to have a discharge capacity sufficient toprovide a thermal energy pulse from the treatment tip of between 0.5J/cm² and 5 J/cm², and to heat the treatment tip to a temperature of atleast 50 degrees Celsius.
 13. The device of claim 12, wherein thetreatment tip comprises a diameter of between 0.2 mm and 10 cm.
 14. Thedevice of claim 12, wherein the capacitor is configured to have adischarge capacity sufficient to provide a thermal energy pulse from thetreatment tip of between 0.5 J/cm² and 5 J/cm², and to heat thetreatment tip to a temperature of at least 50 degrees Celsius.
 15. Thedevice of claim 12, further comprising: a. a user interface on thehand-holdable housing, wherein the user interface comprises: b. a chargebutton configured to effectuate charging of the capacitor when thecharge button is activated by a user; c. a fire button configured tocause, when activated by a user, the controller to trigger the capacitorto release its discharge capacity to the heating element.
 16. The deviceof claim 12, wherein the resistive heater comprises a flat conductor.17. The device of claim 12, wherein the source providing suctionprovides suction at the treatment tip.
 18. A device for treating aregion of intact living skin having a surface and an epidermal/dermaljunction, comprising: a. an energy source; b. a treatment headcomprising a thermal heater, a treatment tip comprising a layer ofthermally conducting material in thermal contact with the thermal heaterand comprising a diameter between 0.2 mm and 10 cm configured to beplaced against a skin surface, wherein the treatment head is configuredto provide a thermal energy pulse at the treatment tip responsive toenergy provided by the energy source; c. a controller that cooperateswith the energy source to provide sufficient energy to the thermalheater to heat the treatment tip and thereby create the energy pulsewith the treatment head, wherein the controller controls and limits theenergy provided by the energy source such that the energy is provided tothe thermal heater to create an energy pulse having a duration of nomore than 100 sec, and the energy pulse delivers an average energydensity of 5 J/cm² or less from the treatment tip, and heats thetreatment tip to a temperature of at least 50 degrees Celsius; and d. asource of suction.
 19. The device of claim 18, wherein said thermalheater is selected from the group consisting essentially of a lightsource, an RF Source, an Ultrasound source, an EM energy source, and anelectric heater.
 20. The device of claim 18, wherein said thermallyconducting material comprises a material capable of transferring saidenergy pulse to the skin.